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Risk of common skin cancer increased by as much as 90 per cent, study finds


Research being presented this week at the World Congress on Cancers of the Skin in Edinburgh, Scotland, shows that sunbeds significantly increase the risk of a potentially serious skin cancer that is twice as common as melanoma.

Warnings about sunbeds often focus on melanoma, the least common type of skin cancer, which is linked to sunburn. Some sunbed operators therefore claim that as long as skin does not burn, there is no cancer risk.

However this latest warning, from researchers at University of Dundee in Scotland and Leiden University Medical Centre in the Netherlands, relates to squamous cell carcinoma (SCC), the second most common type of skin cancer. SCC is caused by longer-term, cumulative exposure to UV, such as through repeated tanning, rather than isolated incidents of burning. SCC accounts for about 20 per cent of all skin cancers, while melanoma accounts for just one per cent.

In January 2013, the same researchers from Dundee published a study which measured ultraviolet (UV) radiation levels emitted by 402 sunbeds across England*. This showed that nine out of ten sunbeds emitted UV levels that exceed European safety limits.

In this latest study, the team used these data on the UV intensity levels, factored in the average length of sunbed sessions, and the number of sessions each year, as well as a person’s cumulative UV exposure from the sun, and then applied an equation that links UV exposure and SCC incidence, to predict risk to people who use sunbeds.

The researchers found that by 55 years of age, people who used a sunbed were 90 per cent (1.9-fold) more likely to develop SCC than those who did not. Sunbed use was defined as having a 12 minute session about every eight days (or a six minute session every four days), over a 15 year period from age 20 to 35 years, using a sunbed with a median UV dose**. For high dose sunbeds the risk is increased by 180 per cent. Even the sunbeds giving the lowest UV dose found in the 2013 study were linked to a 40 per cent increased risk of developing SCC.  

This is the first study to estimate the risk of SCC according to the type of sunbed (high, medium and low output), session time, and number of sessions per year, and consider those in relation to day-to-day exposure and holiday exposure.

Professor Harry Moseley of the University of Dundee, one of the study’s authors said: “There is considerable variation in the output of artificial tanning units which people should be aware of. The results of our study indicate that the additional UV dose from sunbed use compared to normal day-to-day sun exposure potentially adds a significantly increased risk for development of SCC.”

Nina Goad of the British Association of Dermatologists said: “While other types of skin cancer, such as melanoma, are linked to sunburn, SCC is caused by more chronic, long-term, cumulative sun exposure. One defence of the sunbed industry is that sunbeds do not increase your risk of skin cancer if you do not burn, however this study weakens this argument. It is something that people should be warned about, so they are fully informed of the risks when making choices about sunbed use.”

There are two main types of skin cancer: melanoma and non-melanoma skin cancer. SCC is a non-melanoma skin cancer, and the second most common type of skin cancer in the UK. While it results in fewer deaths than melanoma (approximately 500 SCC deaths per year in the UK compared to 2,200 deaths from melanoma), it has metastatic potential (it can spread to other parts of the body) and can have a significant impact on the patient, including extensive scarring following surgical removal.

The most common cause is too much exposure to ultraviolet (UV) light from the sun or from sunbeds. This causes certain cells (keratinocytes) in the outer layer of the skin (the epidermis) to grow out of control into a tumour. SCC can be cured if detected early, however if an SCC is left untreated for too long it may spread to other parts of the body, which can prove fatal. About 23,600 new cases of SCC are diagnosed in the UK each year. However, as not all cases are registered, the actual figure is believed to be far higher.


Notes to editors:


** A Standard Erythemal Dose (SED) is a standard measure of UV dose. The median total sunbed irradiance was calculated to be 0.54 Wm-2 which is equivalent to 3.9 SED for a 12 minute sunbed session. High dose is defined as 302 SED and low dose as 82 SED.

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin. 

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

Study details:

156, Predicted increased risk of squamous cell carcinoma induction associated with sunbed use, Patrick Tierney1, Sally Ibbotson1, Frank de Gruijl2, Harry Moseley11Photobiology Unit, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK, 2Dept. of Dermatology, Leiden University Medical Center, Leiden, The Netherlands

Solar Ultraviolet (UV) radiation is acknowledged as the principle cause of skin cancer. Furthermore, sunbeds have been classified as carcinogenic by International Agency for Research on Cancer.  Therefore an increased risk of developing non-melanoma skin cancer (NMSC) is expected when one is exposed to both sources of UV radiation. The additional risk factor was determined from a squamous cell carcinoma (SCC) tumour induction model based on albino mice1. The risk model for SCC induction was adapted to include the use of sunbedsalong with lifetime cumulative dose from day-to-day and holiday exposure.  The latter two were established as the “baseline” exposure. Age and environmental UVR exposure are the two most important factors in determining the relative risk. Application of meta-analysis with biological amplification factor 2.3 and age dependent factor 3.8 from epidemiological studies is used to estimate risk of SCC associated with the extra dose accumulated with sunbeds. The relative risk was defined as the risk of SCC induction from (sunbed + baseline) / baseline. We additionally investigated the various body-sites, from those normally exposed such as face and arms to more usually unexposed sites. With these scenarios the relative risk of SCC induction from median sunbed exposure output in addition to median baseline sun exposure level was 1.9 at age 55 years. This is the first time that a risk model for skin carcinomas has been developed that includes real sunbed exposure data. It shows that the additional risk associated with sunbed use may be significant, particularly when high output, fast tan sunbeds are used.

1De Gruijl FR, Van der Leun JC. Development of skin tumors in hairless mice after discontinuation of ultraviolet irradiation. Cancer Research 1991; 51: 979-84.
Tierney P, Ferguson J, Ibbotson S et al. Nine out of 10 sunbeds in England emit ultraviolet radiation levels that exceed current safety limits. British Journal of Dermatology 2013; 168: 602-8.


About the BAD


The British Association of Dermatologists (BAD) is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. The BAD provides free patient information on skin diseases and runs a number of high profile campaigns, including Sun Awareness, which runs from May to September annually and includes national Sun Awareness Week in May. Website:

Older men at higher risk of skin cancer: sun safety campaigns too youth-focused

A study being presented next week at the World Congress on Cancers of the Skin in Edinburgh Scotland (September 3rd to 6th), reveals melanoma skin cancer rates in England to be rising faster in older men than any other demographic, suggesting that awareness campaigns might be too youth-focussed.

Conducted by analysts at Public Health England (PHE), the research discovered that the incidence rate of melanoma, the most serious form of skin cancer, is rapidly increasing in the older population, in particular amongst men, raising concerns that current sun safety campaigns are not reaching these groups.

The most common type of melanoma – called superficial spreading melanoma – increased by 12 per cent per year over a 21-year period (1990 to 2010) for men aged 60 and over, surpassing the incidence rates for older women (nine per cent) and younger men (eight per cent). The increase in thicker (more advanced) tumours in older men is also increasing at a greater rate than in other demographics – a 12 per cent increase per year compared to just six per cent in younger men -  suggesting that older men may be seeking medical advice later.

Melanoma is more common on the back in men and it is difficult for patients to spot early changes in a lesion on the back. Furthermore, in older people it is common to develop a variety of harmless lesions on the skin, such as warts. Differentiating melanomas from these is difficult. These two observations may contribute to older men presenting with thicker tumours.

The increase in melanoma incidence rate for older men varied by body site, with the fastest rise on the trunk and upper limbs (both around nine per cent per year), whilst for other demographic groups there was no such variation.

PHE’s findings are mirrored by an earlier study into skin cancer incidence rates in the Scottish population*, which showed rates of melanoma trebling in males between 1979 and 2003 (with 206 cases between 1979 and 1983, and 2073 from 1999 to 2003) and the greatest increases being seen in those aged 60 and over.

Julia Verne, Director of the South West Knowledge and Intelligence Team, Public Health England commented: “Studies into the causes of melanoma have emphasised the importance of excessive UV exposure and especially burning through recreational activities and holidays. The findings of this study highlight the need for education campaigns to target the entire spectrum of people across all demographics about the dangers of sunburn and sunbathing.”

Johnathon Major of the British Association of Dermatologists added: “Older men have continuously proved a problematic group for us to target with skin cancer advice and studies such as these underline the requirement to reach them. We are constantly developing our communication initiatives to tender to wider audiences and target groups such as these who have been demonstrated to be in particular need.With health messaging, there can be an over-reliance on newer technologies such as social media, but these don’t always reach the groups most in need. 

“For this reason we now operate two major sun awareness campaigns each year - Sun Awareness Week and the Be Sun Aware Roadshow, both of which are aimed at all age groups. We try to visit a range of outdoors events, from sporting events to gardening shows, to capture people whose recreational activities mean they spend time in the sun, perhaps unprotected.

“There are two issues at play here – skin cancer rates are rising faster in this group, so we conclude that protecting the skin from sun damage is important for adult men as well as others, and second, there is concern that older men also seem to be presenting later. This shows we need to address both our prevention messages, and our early detection messages, at older people as a matter of priority. ”


For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or at

If using this study, please ensure you mention that the study was released at the World Congress on Cancers of the Skin.

The conference will be held in Edinburgh from September 3rd to 6th 2014, and is attended by approximately 1,000 UK and worldwide health professionals.

The World Congress on Cancers of the Skin 2014 was founded by The Skin Cancer Foundation, the international organization devoted solely to education, prevention, early detection, and prompt treatment of the world’s most common cancer. It is organised by the British Association of Dermatologists.

Study details:

Cutaneous melanoma in older persons, V.Poirier, T.Jones, A.Ives, J. Newton-Bishop and J.Verne

Previous reports from the UK highlighted a higher incidence of melanoma in women. However, we recently reported a considerable and remarkable change in melanoma incidence with the most rapid increase occurring in older people and especially men. We consider here whether this reflects an emerging pattern indicative of a proportion of tumours with a different aetiological route to melanoma.

We examined melanoma (ICD-10 C43) incidence trends (1990-2010) in England using the National Cancer Data Repository. Three cohorts were compared: Males 60+ years (older men), females 60+ years (older women) and males under 60 years (younger men); broken down by the following variables: anatomical site, socio-economic deprivation, tumour morphology, Breslow thickness and previous occurrence of skin cancer.

Directly standardised incidence rates were calculated and Poisson regression was used to model the changes in these rates over time.

Between 1990 and 2010 the melanoma incidence rate for older men varied by anatomical site (p<0.01), with the fastest rise on the trunk and upper limbs. There was no significant variation for older women (p=0.07) or younger men (p=0.89).

Melanoma incidence rates have increased irrespective of deprivation status but rates in the least deprived population increased faster for older men than younger men (7.1% vs. 3.9%; p=0.03).
The incidence rate for superficial spreading melanoma in older men increased faster (12.4%) than older women (8.9%) and younger men (7.9%), although not significantly (p>0.05).

For older men, melanoma incidence rates increased faster for thicker tumours (>4 mm; 11.5%) compared to older women (9.4%) and younger men (6.3%).

Older men had a higher proportion of previous squamous cell carcinomas than older women or younger men (p<0.01), and this proportion increased significantly faster for older men than younger men (p=0.046).

Epidemiological studies have consistently reported evidence that recreational sun exposure rather than chronic sun exposure is associated with melanoma risk. The new data presented here suggest that health promotion campaigns should address the risks associated with recreational sun exposure at all ages, on all body sites including the head and neck, and deliver early detection campaigns to older individuals and especially men.

*Second study: Melanoma incidence and mortality in Scotland 1979-2003, MacKie, R M1; Bray, C; Vestey, J; Doherty, V; Evans, A; Thomson, D; Nicolson, M. Department of Public Health and Health Policy, University of Glasgow, Glasgow G12 8RZ, UK. British journal of cancer 96.11 (Jun 4, 2007): 1772-7.

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